Patient Reaction to Telemedicine for Clinical Management of Hepatitis C Virus Integrated into an Opioid Treatment Program

Telemed J E Health. 2019 Sep;25(9):791-801. doi: 10.1089/tmj.2018.0161. Epub 2018 Oct 16.

Abstract

Background and Introduction: Virtual integration of hepatitis C virus (HCV) infection management within the opioid treatment program (OTP) through telemedicine may overcome limited treatment uptake encountered when patients are referred offsite. To evaluate the diffusion of telemedicine within the OTP, we conducted a pilot study to assess acceptance of and satisfaction with telemedicine among 45 HCV-infected opioid use disorder (OUD) patients on methadone. Materials and Methods: We administered a modified 11-item telemedicine satisfaction questionnaire after the initial HCV telemedicine evaluation, when initiating HCV treatment, and 3 months post-HCV treatment completion. Among a patient subset, a semistructured interview further assessed issues of participant referral to the telemedicine program as well as convenience and confidentiality with the telemedicine encounters. Results: Patients demonstrated their acceptance of telemedicine-based encounters by referral of additional participants. They highlighted the convenience of on-site treatment with a liver specialist through recognition of the benefit of "one-stop shopping." They also expressed confidence in the privacy and confidentiality of telemedicine encounters. Discussion: In this pilot study, telemedicine appears to be well accepted as a modality for HCV management among OUD patients on methadone. Virtual integration of medical and behavioral therapy through telemedicine warrants further investigation for its use in this population. Conclusions: In this pilot study, we found that a largely racial minority population of substance users grew to accept telemedicine over time with diminished privacy and confidentiality concerns. Telemedicine was well accepted within the OTP community as reflected by participant referral to the program.

Keywords: hepatitis C; opioid treatment programs; telemedicine; telemedicine satisfaction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / administration & dosage
  • Combined Modality Therapy / methods
  • Disease Management
  • Female
  • Hepatitis C / diagnosis
  • Hepatitis C / drug therapy*
  • Humans
  • Male
  • Methadone / administration & dosage*
  • Middle Aged
  • Opiate Substitution Treatment / methods
  • Opioid-Related Disorders / diagnosis*
  • Opioid-Related Disorders / drug therapy*
  • Patient Compliance / statistics & numerical data
  • Patient Safety
  • Patient Satisfaction / statistics & numerical data
  • Pilot Projects
  • Risk Assessment
  • Surveys and Questionnaires*
  • Telemedicine / organization & administration*
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Methadone